Male external genitalia self-mutilation in Burkina Faso: Nationwide study of 13 cases

---

Résumé

Introduction: Genital self-mutilation is an
infrequent uro-psychiatric emergency in urological
practice. Many authors have emphasized its rarity in the
literature. In Burkina Faso, the incidence and prevalence are
poorly due to under-notification and the absence of large-scale
studies. We proposed this multicenter study to determine the epidemiological,
diagnostic, therapeutic and evolutionary aspects of
male external genitalia (MEG) self-mutilation in Burkina Faso.
Materials and methods: A retrospective multicenter study was
conducted, including all patients treated for male external genitalia
self-mutilation in 03 referral university hospital centers in
Burkina Faso from January 1, 2018 to December 31, 2024.
Penile and testicular injuries were classified according to the
American Association for the Surgery of Trauma (AAST) classification.
Results: We collected 13 cases of MEG self-mutilation. The average
age was 29.54 years with extremes of 18 and 62 years. All
our patients were single and had a low socioeconomic standard
of living. All the patients had psychiatric history. Lesion assessment
revealed 03 cases of penis strangulation by metal ring, 06
cases of isolated penile section, 03 cases of testicular section +
penile section and one case of isolated testicular section. AAST I
penile lesions were trimmed with haemostasis and simple skin
suture. Urethrostomies and stump regularizations dominated the
procedures performed in cases of AAST V penile section. We
noted a single penile reimplantation without magnifying glasses
in a case of near-complete penile section of the penis AAST IV.
Postoperative follow-up was straightforward in 12 cases and
complicated by necrosis of the reimplanted segment in 01 case.
Sequelae were unsightly and functional in cases of AAST IV and
V section.
Conclusions: Self-mutilation lesions in MEG are varied, and
their management have benefited from the contribution of
microsurgery in developed countries. It remains problematic in
developing countries.

Mots-clés

Self-mutilation; External genitalia; Psychiatric history; Reimplantation without magnifying glasses; Burkina Faso